1. Field of the Invention
This invention relates broadly to surgical devices and methods for the internal fixation of fractured bones, and more particularly, to bone plates and fasteners.
2. State of the Art
Metacarpal fractures are the most common fracture affecting the hand, accounting for about 48% of hand injuries and 12% of all types of fractures. Phalangeal fractures account for about 40% of hand injuries and 10% of all fractures. Displaced metacarpal and phalangeal fractures should be treated with open reduction and internal fixation with screws and very small bone plates.
Bone plate systems for hand fractures are currently available in the small sizes required for placement on metacarpal and phalangeal bones. For example, the Stryker Profyle Small Bone Plating System is specifically designed for fractures of the metacarpal and phalangeal bones. The system includes a set of small plates in several shapes includes straight, T-shaped, L-shaped, and ladder configuration with parallel rails and rungs extending across the rails connecting the locations of various fixation holes. By way of another example, the Synthes Compact Hand system includes straight, T-shaped, and Y-shaped plates for the fixation of fractures of the hand. The plates in the system can be bent in an attempt to approximate the contour of the bone. In order to bend a plate, a pair of pliers are used on opposing sides of the portion intended to be bent, or two rods are threadably coupled directly into a limited number of round threaded holes in the plate and force is applied to the rods to bend the plate. In either method, the plate is bent off the bone through trial and error. In addition, the plates may be trimmed to length and then subsequently deburred, also while off the bone to permit the cutting pliers proper access to the plate.